The Role of Surgery in Antenatal Ovarian Torsion
Antenatal ovarian torsion (AOT) is rare and requires differentiating from other congenital cystic masses of the abdomen and pelvis in neonates. In this study, it was aimed to evaluate the prenatal characteristics and postnatal outcomes of AOT.

Hospital records of patients with the diagnosis of AOT were reviewed and their prenatal characteristics, postnatal examination, imaging, operative, and histopathological findings were evaluated.

There were 28 patients during the study period. The majority of the patients were prenatally detected. Prenatal history was event-free in all and none had additional anomalies. Physical examination revealed mobile intraabdominal cystic lesions in 16 patients.

- AOT mimicked other pathologies as intestinal duplication cyst/mesenteric cyst, complex ovarian cyst, mature cystic teratoma, simple renal cyst, and ectopic kidney in 15 patients in postnatal ultrasonography.

- Elective laparoscopic surgery was performed in 26 patients. Other two patients required emergency open surgery due to presenting with acute symptoms.

- Ovaries were auto-amputated in 17 patients. Histopathological examination revealed necrosis and dystrophic calcification in all specimens.

- There was neoplastic involvement in two patients. No complications occurred in the early follow-up period.

AOTs can be detected easily during the antenatal period. Neoplastic involvement with AOT is rare but possible. Although AOTs may mimic other cystic pathologies, it should be one of the first diagnoses to be considered, in the presence of a palpable intra-abdominal mass and complex cystic lesion in infant girls. It can be efficiently and safely managed by minimally invasive techniques.

Journal of Pediatric & Adolescent Gynecology
Source: https://doi.org/10.1016/j.jpag.2021.08.007
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